• Auditor, HCC Risk Adjustment Coding - Full Time…

    Datavant (Harrisburg, PA)
    …to realize our bold vision for healthcare. As an Auditor, HCC Risk Adjustment Coder , you will review medical records to identify and code diagnoses using ... or GED equivalent + AHIMA certified credentials (RHIA, RHIT, CCS) or AAPC certified credentials ( CPC , CPC -H, COC, CIC or CRC). + Proficient in ICD-10 coding. +… more
    Datavant (08/08/25)
    - Related Jobs
  • Investigator

    Highmark Health (Harrisburg, PA)
    …**Preferred** (any of the following) + Certified Fraud Examiner (CFE) + Certified Professional Coder ( CPC ) + Certified Outpatient Coder (COC) + Accredited ... to prevent further improper payments.Forwards case to the Credentialing and/or Medical Review Committee, law enforcement and regulatory agencies. + Responsible for… more
    Highmark Health (09/10/25)
    - Related Jobs
  • Compliance Audit Manager

    Cardinal Health (Harrisburg, PA)
    …detection and correction of documentation, coding, and billing errors and/or medical necessity of services billed. Particular areas of focus include: evaluation ... physicians, physician leadership, senior leadership, management, and staff; physician and coder education; and the making of recommendations for corrective action to… more
    Cardinal Health (08/27/25)
    - Related Jobs
  • DRG Specialist II

    UPMC (Pittsburgh, PA)
    …Certifications, and Clearances:** + Certified Coding Specialist (CCS) OR Certified Professional Coder ( CPC ) OR Certified Registered Nurse Practitioner OR Doctor ... DRG Specialist II will review clinical documentation within the medical record to ensure that all patient resource utilization,...of care. + Review and evaluate focused UPMC DRG medical records for accurate DRG assignment to ensure that… more
    UPMC (09/25/25)
    - Related Jobs
  • HIM ProFee Auditing Specialist FT

    Datavant (Harrisburg, PA)
    …**What You Will Do:** + Performs Professional Fee coding audits of medical records and abstracts using ICD-10-CM, CPT, HCPCS, and modifiers and appropriate ... to ensure departmental workflow and case resolution + Provides coder education via the auditing process + Function in...5+ years of Professional Fee coding and/or auditing + CPC (required) + CPMA (preferred) + Maintain 95% accuracy… more
    Datavant (09/13/25)
    - Related Jobs
  • MedTech Billing & Coding Contract Specialist…

    Organon & Co. (Plymouth Meeting, PA)
    …related field (Master's preferred). + Professional certifications suggest certified professional coder ( CPC , certified revenue cycle representative (CRCR), or ... Strong understanding of CMS rules, stark law, anti-kickbacks in medical device space. In addition, the role will support...plan, paid vacation and holiday time, paid caregiver/parental and medical leave, and health benefits including medical ,… more
    Organon & Co. (09/06/25)
    - Related Jobs
  • Coding Audit & Education Coordinator

    St. Luke's University Health Network (Allentown, PA)
    …Information Administrator (RHIA); Certified Professional Auditor (CPMA); Certified Professional Coder ( CPC ); Certified); Certified Coding Specialist (CCS); ... coding audit activities. The incumbent will also review and validate coded medical records of the Professional Coding (PC) staff to determine data quality… more
    St. Luke's University Health Network (08/20/25)
    - Related Jobs